---
title: "Pulmonary arterial hypertension burden in China vs the G20: GBD 1990–2023 trends and projections"
id: "pubmed-42701880"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42701880"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42701880/"
doi: "10.1080/07853890.2026.2727194"
published_at: "2026-09-06T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Pulmonary arterial hypertension burden in China vs the G20: GBD 1990–2023 trends and projections
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42701880
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42701880/)
- **DOI:** [10.1080/07853890.2026.2727194](https://doi.org/10.1080%2F07853890.2026.2727194)
- **Published At:** 2026-09-06T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This comparative analysis used **Global Burden of Disease Study 2023** estimates to quantify changes in pulmonary arterial hypertension (**PAH**) burden in China and the G20 aggregate from 1990 to 2023 and to project future trends. - Outcomes assessed included incidence, prevalence, deaths, DALYs, YLDs, and YLLs reported as absolute counts and age-standardized rates. - Temporal trends were evaluated with Joinpoint regression; future projections employed **ARIMA** models for overall burden through 2050 and **Bayesian age-period-cohort (BAPC)** models for sex-specific projections through 2038. - Between 1990 and 2023, incident and prevalent cases and YLDs rose in both China and the G20 aggregate, while deaths, DALYs, and YLLs declined. - In China, prevalent cases rose by 63.5% (from 17,020.87 to 27,834.41), while the age-standardized death rate fell by 74.3% (from 0.29 to 0.08 per 100,000). - The G20 aggregate experienced similar declines in mortality-related age-standardized metrics; sex-specific patterns showed females generally had higher age-standardized prevalence and YLD rates than males. - Absolute burden shifted toward older age groups in both settings; population growth and aging contributed to increasing absolute case numbers, whereas epidemiological change tended to reduce absolute burden. - Projections indicated continued declines in age-standardized mortality-related burden through 2050, concurrent with increasing incident and prevalent case counts, highlighting implications for surveillance and long-term health-service planning. - The study underscores the divergence between decreasing age-standardized mortality and rising absolute case numbers driven by demographic change, and recommends continued monitoring and planning for care of people living with PAH.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 6. # Burden dynamics of pulmonary arterial hypertension in China and the G20 aggregate: a comparative analysis based on the global burden of disease study 2023 [Qizhi Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+Q&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China."), [Ling Hao](https://pubmed.ncbi.nlm.nih.gov/?term=Hao+L&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China."), [Weitao Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+W&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China."), [Chengyi Hu](https://pubmed.ncbi.nlm.nih.gov/?term=Hu+C&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China."), [Yanze Shu](https://pubmed.ncbi.nlm.nih.gov/?term=Shu+Y&cauthor_id=42701880)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#full-view-affiliation-2 "Guangzhou Medical University, Guangzhou, Guangdong, China."), [Wenzhen Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+W&cauthor_id=42701880)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#full-view-affiliation-2 "Guangzhou Medical University, Guangzhou, Guangdong, China."), [Haoyang Hu](https://pubmed.ncbi.nlm.nih.gov/?term=Hu+H&cauthor_id=42701880)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#full-view-affiliation-3 "Medical School of Chinese PLA, Beijing, China."), [Zhuxiang Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+Z&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.") Affiliations Expand ### Affiliations * 1 Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China. * 2 Guangzhou Medical University, Guangzhou, Guangdong, China. * 3 Medical School of Chinese PLA, Beijing, China. * PMID: **42701880** * DOI: [ 10.1080/07853890.2026.2727194 ](https://doi.org/10.1080/07853890.2026.2727194) Item in Clipboard Comparative Study # Burden dynamics of pulmonary arterial hypertension in China and the G20 aggregate: a comparative analysis based on the global burden of disease study 2023 Qizhi Wang et al. Ann Med. 2026 Dec. Show details Display options Display options Format Abstract PubMed PMID Ann Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Ann+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Ann+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42701880/) . 2026 Dec;58(1):2727194. doi: 10.1080/07853890.2026.2727194. Epub 2026 Sep 6. ### Authors [Qizhi Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+Q&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China."), [Ling Hao](https://pubmed.ncbi.nlm.nih.gov/?term=Hao+L&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China."), [Weitao Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+W&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China."), [Chengyi Hu](https://pubmed.ncbi.nlm.nih.gov/?term=Hu+C&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China."), [Yanze Shu](https://pubmed.ncbi.nlm.nih.gov/?term=Shu+Y&cauthor_id=42701880)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#short-view-affiliation-2 "Guangzhou Medical University, Guangzhou, Guangdong, China."), [Wenzhen Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+W&cauthor_id=42701880)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#short-view-affiliation-2 "Guangzhou Medical University, Guangzhou, Guangdong, China."), [Haoyang Hu](https://pubmed.ncbi.nlm.nih.gov/?term=Hu+H&cauthor_id=42701880)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#short-view-affiliation-3 "Medical School of Chinese PLA, Beijing, China."), [Zhuxiang Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+Z&cauthor_id=42701880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42701880/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.") ### Affiliations * 1 Department of Respiratory and Critical Care Medicine, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China. * 2 Guangzhou Medical University, Guangzhou, Guangdong, China. * 3 Medical School of Chinese PLA, Beijing, China. * PMID: **42701880** * DOI: [ 10.1080/07853890.2026.2727194 ](https://doi.org/10.1080/07853890.2026.2727194) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Pulmonary arterial hypertension (PAH) causes substantial premature mortality and disability. Updated evidence comparing long-term PAH burden in China with the Group of Twenty (G20) aggregate remains limited. We assessed changes from 1990 to 2023 and projected future trends. **Methods:** PAH estimates for China and the G20 aggregate were extracted from the Global Burden of Disease Study 2023. Outcomes included incidence, prevalence, deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs), expressed as absolute counts and age-standardized rates. Temporal trends were assessed using Joinpoint regression. Sex-specific and age-specific patterns and demographic decomposition were examined. Autoregressive integrated moving average (ARIMA) models projected overall burden through 2050. Bayesian age-period-cohort (BAPC) models projected sex-specific patterns through 2038. **Results:** From 1990 to 2023, incident and prevalent cases and YLDs increased in both settings, whereas deaths, DALYs, and YLLs declined. In China, prevalent cases increased by 63.5%, from 17,020.87 to 27,834.41, while the age-standardized death rate decreased by 74.3%, from 0.29 to 0.08 per 100,000 population. Similar declines in mortality-related age-standardized indicators occurred in the G20 aggregate. Females generally had higher age-standardized prevalence and YLD rates than males, although sex differences in mortality-related outcomes varied by setting. Absolute burden shifted toward older age groups. Population growth and aging contributed to increases in absolute burden, whereas epidemiological change generally acted in the opposite direction. Projections suggested continued declines in age-standardized mortality-related burden through 2050, alongside increases in incident and prevalent case numbers. **Conclusion:** Mortality-related PAH burden declined in China and the G20 aggregate, while absolute case numbers increased. Population growth and aging contributed to this divergence, underscoring the need for continued surveillance and long-term health-service planning. **Keywords:** ARIMA model; China; G20 aggregate; GBD 2023; population aging; pulmonary arterial hypertension. ## Plain language summary Pulmonary arterial hypertension is a serious disease affecting the blood vessels of the lungs and can lead to right heart failure and premature death.We used data from the Global Burden of Disease Study 2023 to compare changes in PAH burden in China and the G20 aggregate from 1990 to 2023 and to project trends through 2050.In China, the number of people living with PAH increased by approximately 64%, while the age-standardized death rate decreased by approximately 74%.Females generally had higher prevalence and rates of disability than males, although sex differences in death-related outcomes were not consistent between China and the G20 aggregate.The absolute burden increasingly shifted toward older age groups. Population aging and population growth contributed to the increasing number of people affected.Future declines in death-related burden may therefore occur alongside continued growth in the number of people living with PAH, with implications for disease surveillance and long-term care planning. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Global, Regional, and National Burden of Pulmonary Arterial Hypertension from 1990 to 2021 and Projections to 2040: A Systematic Analysis of Incidence, Mortality, and Disability-Adjusted Life Years. ](https://pubmed.ncbi.nlm.nih.gov/40971086/) Yu LL, Jiang DS, Wang X, Fang ZM, Chen WH, Zhao JZ, Yi X, Liu W.Yu LL, et al.Curr Med Sci. 2025 Oct;45(5):1068-1078. doi: 10.1007/s11596-025-00108-1. Epub 2025 Sep 19.Curr Med Sci. 2025.PMID: 40971086 * [ The trend analysis and comparison of pulmonary arterial hypertension disease burden in China and India from 1990 to 2021: a study based on the Global Burden of Disease 2021 database. ](https://pubmed.ncbi.nlm.nih.gov/41382242/) Chen X, Yan D, Liu C, Dai J, Li Z, Lu Y.Chen X, et al.Eur J Med Res. 2025 Dec 11;31(1):78. doi: 10.1186/s40001-025-03489-0.Eur J Med Res. 2025.PMID: 41382242Free PMC article. * [ Trends and future of the disease burden of malignant neoplasms of bone and articular cartilage in China from 1990 to 2023: An analysis based on the Global Burden of Disease 2023. ](https://pubmed.ncbi.nlm.nih.gov/41980408/) Zheng J, Yu W, Lou Y, He X, He S, Zhou H, Gao X, Sun W, Fang B, Wang S, Yin M.Zheng J, et al.Eur J Surg Oncol. 2026 Jun;52(6):111800. doi: 10.1016/j.ejso.2026.111800. Epub 2026 Apr 12.Eur J Surg Oncol. 2026.PMID: 41980408Review. * [ Burden and trends of decubitus ulcers in East Asia, 1990-2021, with projections to 2031: a comprehensive analysis of the global burden of disease study. ](https://pubmed.ncbi.nlm.nih.gov/41630079/) Wang L, Liu Z, Zhu X, Zhou Y, Zhao S, Zhao C, Liang H, Zhang J, Gao T, Ding Y.Wang L, et al.J Health Popul Nutr. 2026 Feb 2;45(1):80. doi: 10.1186/s41043-025-01210-9.J Health Popul Nutr. 2026.PMID: 41630079Free PMC article. * [ Updated trends in the global prevalence and burden of mental disorders, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. ](https://pubmed.ncbi.nlm.nih.gov/42167272/) GBD 2023 Mental Disorder Collaborators.GBD 2023 Mental Disorder Collaborators.Lancet. 2026 May 23;407(10543):2040-2064. doi: 10.1016/S0140-6736(26)00519-2.Lancet. 2026.PMID: 42167272 [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42701880) ## Publication types * Comparative Study Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Comparative+Study%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Comparative+Study) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42701880/) ## MeSH terms * Adolescent Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adolescent%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adolescent) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42701880/) * Adult Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adult%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adult) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42701880/) * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42701880/) * Bayes Theorem Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Bayes+Theorem%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Bayes+Theorem) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42701880/) * China / epidemiology Actions * [ Search in PubMed ](https:
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